Healthcare Provider Details

I. General information

NPI: 1598551988
Provider Name (Legal Business Name): SARA SCHMIDT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 DALE ST S
SAINT PAUL MN
55102-2812
US

IV. Provider business mailing address

1866 WELLESLEY AVE
SAINT PAUL MN
55105-1615
US

V. Phone/Fax

Practice location:
  • Phone: 612-220-7538
  • Fax:
Mailing address:
  • Phone: 612-220-7538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARA SCHMIDT
Title or Position: OWNER, LICSW
Credential: LICSW
Phone: 612-220-7538